Background
Utilization of maternal healthcare services is a proximate determinant of maternal
morbidities and mortalities. Considering the differences in maternal health services
use across the six geopolitical zones of Nigeria, understanding the factors that
influence utilization becomes important.
Objective
To explore the differential factors affecting utilization of maternal health services
across the six geopolitical zones of Nigeria.
Study design
An analytical ecological study design which involved the analysis of secondary data
on utilization of maternal health services based on Andersen's Health-seeking
Behavioural Model.
Method
Data from the 2008 National Demographic and Health Survey was analysed to
determine which socio-demographic factors predict utilization of maternal healthcare
services (MHCS) in the different regions of Nigeria. Four dependent variables –
antennal care, skilled attendance at birth, place of delivery and postnatal care – and
seven independent variables representing predisposing factors (mother's age at
birth, religion, birth order, educational attainment and occupation) and enabling
factors (family wealth index and place of residence) were selected. Descriptive v
statistics and logistic regression analysis were applied to the data collected, to
understand the pattern of MHCS utilization and to assess the differential factors
affecting utilization across the regions.
Results
Utilization of MHCS varies across the regions of Nigeria. Generally, women in the
southern region are more likely to utilize services compared to those in the north.
There are differentials and commonalities in the predictors of MHCS utilization in the
regions. Education, family wealth index and place of residence are strong predictors
of service utilization in all the regions. However, some factors are significant
predictors in one region but not in the other. These include employment in the
northern region; and mothers age and religion in the south.
Conclusion
The factors that affect utilization of MHCS are different in the two regions of Nigeria.
Strategies to promote MHCS utilization should focus on the relevant predictors for
each region.